Day Hospital and Residential Addiction Treatment: Randomized and Nonrandomized Managed Care ClientsJournal of Consulting and Clinical Psychology, Volume 75, Issue 6, December 2007, Pages 947-959
Male and female managed care clients randomized to day hospital (n = 154) or community residential treatment (n = 139) were compared on substance use outcomes at 6 and 12 months.
To address possible bias in naturalistic studies, outcomes were also examined for clients who self-selected day hospital (n = 321) and for clients excluded from randomization and directed to residential treatment because of high environmental risk (n = 82). American Society of Addiction Medicine criteria defined study and randomization eligibility.
More than 50% of followed clients reported past-30-day abstinence at follow-ups (unadjusted rates, not significant between groups). Despite differing baseline severities, randomized, self-selecting, and directed clients displayed similar abstinence outcomes in multivariate longitudinal models.
Index treatment days and 12-step attendance were associated with abstinence (p < .001). Other prognostic effects (including gender and ethnicity) were not significant predictors of differences in outcomes for clients in the treatment modalities.
Although 12-step attendance continued to be important for the full 12 months, treatment beyond the index stay was not, suggesting an advantage for engaging clients in treatment initially and promoting 12-step attendance for at least a year.
Request Reprint E-Mail: jwitbrodt@arg.org
________________________________________________________________
